Provider Demographics
NPI:1164607867
Name:MORFOOT, JOSEPH B (OD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:B
Last Name:MORFOOT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-2628
Mailing Address - Country:US
Mailing Address - Phone:224-678-9043
Mailing Address - Fax:224-678-9416
Practice Address - Street 1:204 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-2628
Practice Address - Country:US
Practice Address - Phone:224-678-9043
Practice Address - Fax:224-678-9416
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010058152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist